The Meadows

Updated 12 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector.

Service and service type

The Meadows is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided. We spoke with six members of staff including the registered manager, assistant manager, three care workers and the cook. We looked at four people's care records, medicine records and other records related to the running of the home.

After the inspection

We continued to seek clarification from the provider to validate evidence found. The registered manager sent further information (for example training data and quality assurance records). We also spoke with two relatives of people by phone.

Updated 12 October 2019

About the service

The Meadows is a care home providing short stay and respite care for adults with a learning disability or /and autism. Some people who used the service also had a physical disability. The service was registered to accommodate a maximum of 12 people, and eight people were living at the home at the time of our inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than a domestic style property and was adjacent to other services that used space in the building as offices, these with separate dedicated entrances. These services were also managed by the provider, for example shared care services. The Meadows is registered to accommodate 12 people. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design offering a range of high-quality facilities, as well as extensive internal and external space which enhanced people’s experiences. In addition, the service did not offer a permanent residence for people, only short breaks which some people likened to stopping in a hotel for a holiday. Support staff did not wear anything that suggested they were care staff when coming and going with people and transport used by the service was not identifiable as anything other than family transport.

People’s experience of using this service and what we found

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of the thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

People and relatives told us the service was safe and staff were very aware of how to minimise risks to people and promote their safety, without compromising their freedom. Staff knew how to work with people to identify risks and change their approach to minimise these.

People were supported by care staff that were caring, showed compassion and expressed genuine interest about the people they cared for. People received person centred care and support based on their individual needs and preferences. Staff were knowledgeable about people, their needs and preferences and used this to develop a good relationship with the people who stayed at the Meadows.

People were supported by care staff who had the skills and knowledge to meet their needs. Staff understood, felt confident and well supported in their role. People's health was supported as staff worked with other health care providers when needed to support people’s healthcare needs.

People were supported to have maximum choice and control of their lives and staff understood they should support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they enjoyed meals they chose and there was access to a range of foods that met people’s needs due to their health, culture or specific preferences.

People's care plans reflected people’s needs and preferences and the staff were able to explain how people were involved to ensure care plans were current, person centred and fully involved people and their wider family. We saw the service was responsive to information from people and relatives.

People knew how to complain and felt concerns would be listened and responded to by the staff. Complaints and comments were used as a tool to drive improvement of the service.

People, relatives and staff gave us a positive picture as to the quality of care people received, and said they were able to share their views with staff. People enjoyed their stays at the Meadows and said they were able to follow their chosen routines and enjoyed access to activities at the service.

Quality monitoring systems included audits, regular checks on people’s satisfaction with the service they received, by surveys, phone calls, social events or meetings. The provider has systems in place to ensure they kept up to date with developments in the sector and changes in the law.

People and relatives told us the registered manager and staff were approachable, organised, listened and responded to them and acted on feedback when they shared this with them. The registered manager had high expectations in respect of the quality of the service. This reflected the views of staff. People and relatives told us the service they received was to a high standard. The registered manager demonstrated they were not complacent and wished to improve the service further, for example developing support networks for people so the service was more inclusive.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was ‘good’ (published 12 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.